Advice for insurance professionals working with a client who has a mental health condition

If you work in the insurance industry, you will encounter people who have a mental health diagnosis. We explain how to support your customers to get them the most suited insurance cover.

Unfortunately, there is still a stigma associated with mental illness and insurance, resulting in people feeling uncomfortable talking about their mental illness with insurance professionals.

A Mental Health UK survey found that 33% of people with a mental illness had not applied for any form of protection insurance because the thought of talking about their mental health was too distressing.

Of those who applied for protection insurance:

• 57% were not adequately warned that the questions could cause them distress.
• 40% felt that the questions asked were insensitive.
• 62% were unaware of how their answers would inform the insurance decision-making process.
• 45% felt distressed after the application process.

Making financial decisions can be difficult and stressful for many people, but for those with mental illness, confusion around insurance products can exacerbate their conditions.  So it’s essential to take time to make sure your customers understand the different insurance products. 

How to approach conversations about someone's mental health

Often, you will need to ask customers personal questions about their medical history, including information about their mental health.

People who have mental illnesses can often feel stigmatised and may find it distressing to have to disclose personal information to a stranger. Here are some guidelines to follow:

• Explain that you are about to ask questions about their medical history, and this will include information about their mental health.
• Explain why this information is needed - so insurers can make the right decisions about offering the best insurance products for them.
• Explain that you understand answering some of the questions will be difficult for some people. Also, make sure they know that they can take a break from the conversation at any time if they need.
• Explain that the information they give you is confidential, and will only be used for their insurance application.

The TEXAS model

The TEXAS model was developed by the Money Advice Trust and the Royal College of Psychiatrists.

It was initially intended to be used as a way for financial organisations to have supportive conversations with vulnerable customers who had problem debt.

Still, the model can be equally useful in the insurance world. It will help you to manage communications when a customer discloses a mental illness. Here's how it works:

T – Thank the customer for telling you the information.

This sets up a background of empathy and respect for the rest of the conversation. You may want to add that you appreciate it can be difficult for people to disclose a mental illness to a stranger.

E – Explain how the information will be used.

At this point, you can tell the customer that information about their mental health may be used to inform decisions about their insurance.

You may have already done this when setting up the conversation, but it can be useful to reiterate this.

You do not need to give definitive information (for example, telling them that they will be refused, or that their premium will be more expensive). Still, a brief conversation about how insurers approach risk-based decisions is helpful.

X – eXplicit consent.

A diagnosis of any health problem, including mental illness, is special category data under GDPR. Therefore, you must ask for explicit consent from the customer to record the information they give you.

A – Ask some key questions

For some people, having a mental illness affects how they interact with organisations. So you should ask if their illness affects the way that they want to communicate with you.

For many customers, the answer to this question will be no. But for those that do require a change (for example, having information given to them in small chunks, or avoiding the use of jargon) it will be critical to their conversation with you.

You can ask them how they prefer to communicate with you. They might prefer email, as they might find phone conversations difficult. Or verbal communication might be better for them, instead of written.

S – Signpost

You may want to signpost your customer to other forms of support, for example, a vulnerable customers team if you have one in your organisation. If your customer is distressed, you may need to signpost them to other forms of support.

Distressed Customers

Talking about their mental health issues may result in someone feeling upset or distressed. Often, this can be safely managed by allowing the customer time to compose themselves, and moving forward with the conversation when they are ready.

You can ask the client if they'd like to skip the questions about their mental health for now and come back to them later in the conversation.

At other times, this is not suitable, and you may need to ask the customer if they would prefer to continue the process at a later date. In this scenario, you should check if the customer feels that they need support now and signpost them to it.

This may be an emotional support helpline such as the Samaritans, or a health professional involved in their care that they can contact. For some people, it will be as simple as a trusted friend or family member.

There may be times when you are concerned about the customer's welfare. For example, if they disclose that they are currently experiencing thoughts of self-harm or suicide.

In this situation, you can sensitively ask questions to work out if there is an immediate risk. People who are having thoughts of suicide or self-harm are usually willing to talk about it, so do not be afraid to ask. You can ask things like:

• How long have you been feeling this way?
• Have you got plans to kill yourself or self-harm?
• How serious are you now about acting on your plans?
• Are you alone?
• Do you have a crisis plan with people you can contact?
• Do you have a mental health support team?
• Do you have friends or relatives who you can contact?

If you believe the customer is at immediate risk, you should try and signpost them to the most appropriate form of support.

In most cases, the customer will be capable of getting help for themselves, for example, by contacting people in their crisis plan, in their mental health team or friends and relatives. Other options for the client are:

• Calling their local NHS crisis team – they can search the internet for details or call NHS 111.
• Ask their GP for an emergency appointment.
• Go to Accident and Emergency (A&E) at their local hospital.
• Call 999 for urgent help.
• Call NHS 111 for non-urgent help and advice.
• Call an emotional support line, such as The Samaritans, Sane Line or Support Line or use the Shout text crisis service by texting Shout to 85258.

If the client is not willing to seek help for themselves, with their consent, you can offer to do this on their behalf. You can ask the client who they want you to contact. This might be a healthcare professional, a relative, or friend of the client.

If the client does not want you to contact someone on their behalf, you will need to think about whether to break their confidentiality.

You should only break the client's confidentiality if you have serious concerns about their safety or the safety of someone else. If you have details of their healthcare professionals, you can call them. Or you can call the police and ask for a Safe and Well Check, or a relative or friend.

If you work for an organisation, they will more than likely have a policy for this situation. If you are self-employed, you may wish to seek support from an organisation about how to deal with these situations in the event they do arise. Mental Health UK's training and consultancy team may be able to help you.